Permit Ir CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00179
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/8/2007
PARCEL: 1 S133DB -07400
SITE ADDRESS: 13456 SW HAWK'S BEARD ST BLDG K ZONING: R -25
SUBDIVISION: SUMMER CREEK APARTMENTS LOT: JURISDICTION: TIG
PROJECT: SUMMER CREEK APTS
Project Description: Install low voltage fiber optics for Verizon.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
SUMMER CREEK LLC NORTH SKY COMMUNICATIONS INC
121 SW MORRISON STE 1000 PO BOX 87550
PORTLAND, OR 97204 VANCOUVER, WA 98687
Phone: Contact #: PRI 503 209 - 7521
FAX 866 - 743 -3974
FEES Reg #: ELE 17- 154CLE
LIC 141171
Description Date Amount
[ELPRMT] ELR Permit 6/8/2007 $75.00
[TAX] 8% State Surcha 6/8/2007 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: - , // Permittee Signature: Q a A i /1 r�
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
06/07/2007 THU 10:16 FAX 360 254 5097 North Sky Communications 0011/020
' 47 . VIVA ,5 u - rai c ell I fbat .0.2- -5v - :
Electrical Permit Application '' , .
(� . ( FOR OFFICE USE ONLY
City of Tigard ti `; ' \ t l R eceived �0 E
! , I 13125 SW Hall Blvd., Tigard, OR 97223 Date/By; t � � P ermit No .: � �_ gy
Phone: 503.639.4171 Far: 503.598.I960 U N (.9 c L Plan Review , I
TfGARD Inspection Line: 503.639.4175 Date/By: Other Permit:
Internet www t1 rd or o r ih� Date R B ead l 0 Page Z for
g Noufred/Jdethod:
� �,� 1�L� a y--, � Supplemental Information
� , �; •� fat y :;<c �t �'', t � .`� t sN'��, ';.+. � v ' 7}s-r�, '�a�'r, r�4 � c , "'a�a� �£ it -a.i s'r, ti .s z� -, , ...
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bLi >' i.r ' r.,,c._, `" ' 1t ^` { �f' l e r .r•rap L1 G�7. {7, e a +&r 1L): ,
���.:a �,'k.. a b..ti�a..�.� . - �4.�t's�..r.,r.:r�.�,��z:.::.. 4,; .,`�.t � s+�, 1° a a4 sf�:i a
�.t,' a.r: -.M a�'`P•aa'c -� ',..J?., at #ti
❑ New construction Addition /alteration /replacement Please check all that apply (submit 2 sets of plans whims checked below):
❑ Demolition ❑ Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories.
fl
}r u t � n a g , ,� where the available fault current
45a"'rhJaCU ��sr aw h � �.� tvx tF� ❑Marinas and boatyards.
fi. ,i c..r;... � #,� t !;, � e �n z " 01'x;A 1 tW l , V b „ x x exceeds ojm, amps a i50 volts or ❑FJeati buildings.
❑ 1- and 2 dwelling Jess to ground, other 14,OD0 ❑ Commercial -use agricultural
- Y g ❑ Commercial /industrial ❑ Accessory building amps for ati other installations, buildings.
►2 Multi family ❑ Master builder
s° ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
9 Y � u._ � A 3: k ,li' tf < r?10t T ' ; ❑Emergency system, larger separately derived system,
• � . . ,,1 .,y + ,,. _' a u - u'. ". h ❑ Addition of new motor load of ❑' A °, „ E ., , «1_2° l 3 '
Job no.: !A a / Job site address: rb / I DHP or more, occupancy,
�1 ��3� /rl'i�� ❑Six lO or more residential units. ❑ Recreational vehicle parks.
UITO ❑ Health-care facilities. O Supply voltage for more than
❑ Hawrdous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 4 Project name: C
f ,/ /Q i v.., ❑Service or feeder 600 amps or more
Cross street/directions to job site: v t' h W i ptinn a °„ y ; � )t s Il i 1� y 1
•
neaeripHnn Qtr. ,Fee. Total
r New residential single- or multi - family dwelling unit,
j 4 -� ��• Includes attached garage.
1,000 sq. R, or less
Lot no.
Subdivision: 9• 145.15 4
Tax inaplparcel no.: Ea. add'I 500 sq. ft. or portion 33.40 1
�- c el 3
�+ s ,� ��;'� ��s t ,�„i�`�, � a t�, t � -�����, �, , Yr t t v ast r �"r' xi � � �, Limited energy, residential
'` e lr , M ,., i t � a VI w t``]n�a RI s ' N� � � � ; sq. ft.) 75.00 2
�„ .�, a�; r. <x,1„/.�J,�. s. ';�W'���Ei,�..n._.,�r � i�£r� wth above i
r �E I L i ( mited energy, multi - family 75.00 2
residential • (with above sq. ft)
Services or feeders installation, alteration, and/or relocation
C ip 200 amps or less
E '�' °S�� ��� ��k '� ° � � � � - ��£t,��i ��`nt�,�z� �t�t .taa��' eaar' a �� p 80.30 2
,
��, huz.uxS . a tv.�u.: �,s�,3s.: ir,( a,. , Igg ,. +,.....r..:ns i N . k i� in 201 amps to 400 amps 106.85 2 .
Name: _ 401 amps to 600 amps 160.60 2
Address: 60] amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
City/State /ZIP: • Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 1 66.85 I 1 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
• y on? s I, t � r y 1 _ a S h Q A. Fee for branch circuits with
z::� `�'4. �;; � � tf: ^ �. Yt'•3 i Y.. Yt p i`� µ. ,,, °$ L'.J L:'rat t'. "G9 g� ;f Y f2
.. ;� a'P i; x.� o.,:'."!y $„r'�.' . ,.n A r'+.,a .xrn...._ = s&r,�'. _.. »S Z>, +. tf, '.`1�kteftl X, s ,r''_...,. ,d”' . + above branch ci or rcuit feeder fee 6'65 2
Business name: , V l IA Ova* r an each branch circuit
.� L B. Fee for branch circuits
Contact name: !:. without service or feeder fee,
u ' first branch circuit 46.85 2
Address: I i ! 4: .11 V 0 �.t 'L Etich Wee branch-circuit 6,65 2
City/State/ZIP: JZIP: 1 Miscellaneous (service or feeder not included)
'g i , V V : A t�� A Q � b � � � Each manufactured or modular 90.90 2
)))' ''� , 1 , rt Wi Reconnect service and /or feeder
Phone: (60
�Ti/�s�II>< � F ax:: ( "T� Reconnect only 66.85 2
N 0 A ( C b'1 1 /1
"�� � �`.c >�fi3' ul�f�,- ?�` y'"'' v "`�" �" 2 ,„.. r.� uM tr i� �+ Pump or irrigation circle 53.40 2
c
.a ` r� ' r� , gUNK; -1€ o Lie � rt., ' . c `' °� Sign or outline lighting 53.40 2
Business name: ' /� , +` f� Signal circuits) or limited -
l� V energy panel, alteration, or
Address: extension. Describe: I Page 2 16 2
City/State/ZIP: Each additional Inspection over allowable in any of the above
Phone: ( ) Fax: ( ) Per inspection 62.50
Investigation per hour (I hr min) 62.50
CCB Lie.: w Electrical Lie.: Suprv. Lie.; Industrial plant per hour 73.75
Suprv. Electrician signature, required: ., ..,,. , gag*
Subtotal:
Print name: Date: Plan review (25% of permit fee):
r State surcharge (8% of permit fee): (l to
Authorized signs � ` TOTAL PERMIT FEE: %1 -
Print name: �' l ` (� C� V ' Date: / This permit application expires if a permit is not obtained within 180
• days after It has been accepted as complete.
r: tBuildiagtperatitslELGPermitApp .doc 05/23/06 r Number of inspections allowed per permit.
440- 4615T(11 /aS /COM/ WEB
,.
Q.2k,. 25 (i a
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00179
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/8/2007
Phone: (503) 639 -4171 I
Inspection Requests (24 Hrs.): (503) 639 -4175 �..'W I_..
INSPECTION WORKSHEET FOR DATE: 6/19/2007 TIME: 7:01AM PAGE: i7
SITE ADDRESS: 13 466 SW HAWK'S BEARD ST BLDG K` 1 / CLASS OF WORK:
SUBDIVISION: SUMMER CREEK APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: SUMMER CREEK APTS
DESCRIPTION: Install low voltage fiber optics for Verizon.
OWNER: SUMMER CREEK LLC, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 503. 209-7521
Inspection Request Scheduled For: Date: 6/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 050482 -01 503-519-7466 - N
Corrections /Comments/ Instructions:
PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED •
Inspector:.. • Date: 6-19-04 Phone #: (503) 718 -
e,,